Anti-Medicaid expansion bill passes House
March 12, 2013
A bill that would prevent the governor and Utah Department of Health from expanding Medicaid in Utah passed the Utah House of Representatives on Monday by a large margin.
H.B. 391, Second Substitute Prohibition of Medicaid expansion, sponsored by Senator Jacob Anderegg, prohibits the governor or Department of Health from expanding Medicaid.
"Medicaid expansion gives a false promise with a devastating false hope," Anderegg said.
Anderegg argued that the Utah Health Department reported that costs will increase up to $248 million to provide coverage for an additional 131,500 in FY 2014; spending will increase 732.4 million as the state increases to 160,100 by 2021.
"That is above and beyond what the federal government will cover," he said. "It’s just not sustainable."
The federal government has offered to pay the full cost of the programs in participating states for three years, then phase down to 90 percent of state Medicaid expansion costs.
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Anderegg said the second issue he has with the program is that the federal money is not guaranteed.
"They dangled the carrot and said, for the first three years, you will have to cover nothing; it will be a net positive to you," he said.
Anderegg agreed that the numbers do indicate a net profit of $200,000 to Utah in 2014.
"But can the government really guarantee that money?" he asked. "One thing this body knows, because we’ve seen it in Congress, is that current legislators cannot tie the hands of future legislators Not only that, but the financial status of our government is federal government is becoming weaker and weaker."
Mike Kennedy, R-Alpine, a physician, spoke in favor of the bill and offered an alternative plan to the Medicaid expansion.
Kennedy said that as a dedicated member of Utah’s predominant faith, he spends four hours a week with his Boy Scout troop.
"So what if Dr. Kennedy applied that four hours a week to charity care?" he asked. "Is that something that would provide health care? Absolutely it would. Start doing the numbers. Four hours of care a week for a year, and you get a significant contribution. What if a small percentage of the doctors in the state were willing to commit to a certain hourly contribution per week?"
Rebecca Chavez-Hauck, D-Salt Lake City, spoke against the bill, saying she had recently been reflecting on testimonies she heard in front of the Social Services Appropriations Committee.
"They have, in some cases, a myriad of disabilities," she said. "But it was so important for us to hear their stories, to hear about how the services we provide as a collective give them new hope."
For example, services from the Office of Rehabilitation allow them to go to work so they can pay, in part, for the services they need, she said.
"But for the challenge we have with the 138 percent benchmark level that would be provided with the Medicaid expansion, they might be able to make just a little bit more and not have to depend on the rest of us quite so much," she said.
The Summit County Council signed a resolution on March 6 supporting the Medicaid expansion.
Summit County Health Department Director Rich Bullough said that a "huge amount" of county resources are directed toward providing substance abuse treatment for people referred through the county courts and jail.
"About 98.7 percent of the clients who receive substance abuse treatment are uninsured," he said. "It is estimated that about 50 percent of the individuals receiving that treatment would be eligible for Medicaid under the proposed expansion. So figure the amount of our resources that are going to clients that are cycling in and out of jail and the court systems. We’ve shifted resources to more directly impact the frequent fliers, but we are still extremely limited."
Bullough said that the expansion would not only stretch the county’s limited resources, but would also provide longer term care so fewer people are cycling through the court and jail system.
Under the expansion, a family of three making $25,000 would qualify for Medicaid.
The bill will now move to the Senate for consideration. If the Senate passes the bill, Herbert could veto it.
Gov. Gary Herbert is charged with the final decision on the Medicaid expansion, but said he plans to make the decision after the Legislative session, following the release of a study on the cost-benefit of Medicaid expansion in Utah.